Provider Demographics
NPI:1669015152
Name:HOTCHKISS, RITA EVA ADELINA (PEER COUNSELOR)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:EVA ADELINA
Last Name:HOTCHKISS
Suffix:
Gender:F
Credentials:PEER COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 SE ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-3031
Mailing Address - Country:US
Mailing Address - Phone:360-266-5024
Mailing Address - Fax:360-359-7737
Practice Address - Street 1:6700 MARTIN WAY E STE 117
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98516-5586
Practice Address - Country:US
Practice Address - Phone:360-413-6910
Practice Address - Fax:360-413-9026
Is Sole Proprietor?:No
Enumeration Date:2019-10-28
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60783153175T00000X
WA61028914101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No175T00000XOther Service ProvidersPeer Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA201772584WAMedicaid